Accessory cell signals regulate Th-cell responses: from basic immunology to a model of helminthic disease

Schistosome helminths inflict serious tissue damage by eliciting T helper (Th)-cell-mediated granulomatous inflammation around parasite eggs. The egg granulomas are large in acute disease and smaller in chronic disease. To explain this downregulation in chronic disease, Miguel Stadecker and Pedro Flores Villanueva describe a mechanism whereby CD4+ Th1-type lymphocytes, which are associated with the initial vigorous granuloma formation, are rendered anergic to subsequent antigenic stimulation. This results in the reduction of granuloma size and in the dominance of Th2-type lymphocyte responses.